Provider Demographics
NPI:1851755359
Name:URGENT CARE OF CHESTNUT HILL, LLC
Entity Type:Organization
Organization Name:URGENT CARE OF CHESTNUT HILL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENKARE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:203-885-0808
Mailing Address - Street 1:2928 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1007
Mailing Address - Country:US
Mailing Address - Phone:860-657-8289
Mailing Address - Fax:203-905-6824
Practice Address - Street 1:1210 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2109
Practice Address - Country:US
Practice Address - Phone:860-657-8289
Practice Address - Fax:203-905-6824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care